Yellow fever may be resurfacing in the United States, thanks to climate change. The mosquito-borne viral illness decimated southern U.S. cities from 1820 to 1905, and now a new report says it could return to those areas. One of the potential reasons for a yellow fever resurgence? Global warming, because mosquitoes love warm, wet weather. Exactly where yellow fever may turn up in the United States is not known, but historically outbreaks occur in the southern U.S. along ports such as New Orleans, Galveston, Texas, and along the Mississippi River, said study author Dr. Peter Hotez. He is the dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Texas Children’s Hospital Center for Vaccine Development in Houston. Symptoms of yellow fever range from a fever with aches and pains to severe liver disease with bleeding and yellowing skin (jaundice). There is no treatment or cure for yellow fever, but there is a vaccine available. “There has been an increase in small outbreaks of mosquito-transmitted infections such as malaria, dengue, chikungunya and Zika virus in the southern U.S., especially Florida and Texas,” Hotez explained. “Yellow fever has expanded from the Amazon region into a more populated area of Brazil, so there are concerns that it could also re-emerge here.” It’s time to expand mosquito-transmitted virus surveillance, especially in…  read on >  read on >

An inexpensive medication long used for depression and migraines now has a clinical trial to back up its off-label use for another condition that lowers quality of life: irritable bowel syndrome (IBS). In the study, British researchers found that those taking amitriptyline were almost twice as likely as those taking a placebo to see an improvement in IBS symptoms. “We were delighted that the drug was both effective and safe for IBS when used at a low dose and titrated [slowly increased],” said Dr. Alexander Ford, a professor of gastroenterology at Leeds Institute of Medical Research at St. James’s at the University of Leeds. About 1 in 20 people worldwide live with the abdominal pain and bowel issues that are hallmarks of IBS, a chronic condition with no known cure. “IBS has a substantial impact in terms of affecting social activity, ability to work, out-of-pocket expenses and quality of life for sufferers,” Ford said. Although there are other treatments, most have only a modest impact, according to the study, with people often still suffering symptoms. “First-line treatments do not work for many patients with IBS, so there is a real unmet need as there are few other available therapies in the U.K. and the impact of IBS on the individual, health care systems and society as a whole is substantial,” Ford said. Amitriptyline is part…  read on >  read on >

Many breast cancer survivors take a hormonal drug after cancer treatment to stave off a recurrence, but new research suggests these drugs may be less effective in women who are obese. Breast cancer cells in hormone-positive breast cancers are fueled by the female sex hormone estrogen. Aromatase inhibitor medications lower estrogen levels by stopping an enzyme in fat tissue called aromatase from changing other hormones into estrogen. When compared to breast cancer survivors of normal weight, women who were obese were 18% more likely to have a recurrence even when taking an aromatase inhibitor, and this increased risk was even higher among survivors who were severely obese, the investigators found. “Postmenopausal women with hormone receptor-positive breast cancer and obesity who are treated with aromatase inhibitors at are increased risk of having a recurrence of their disease,” said study author Sixten Harborg, a researcher in the department of oncology at Aarhus University Hospital in Denmark. However, he added, “Treatment with aromatase inhibitors is still the treatment choice for this patient group and lowers the rate of breast cancer recurrence and [death] in this patient group.” Exactly how, or even if, obesity increases the risk of breast cancer recurrence in women taking aromatase inhibitors is not fully understood yet. “Obesity can affect the response to cancer treatment, as obesity alters drug metabolism and distribution,” Harborg noted. Fat…  read on >  read on >

A breast cancer diagnosis often causes anxiety and depression, but an empathetic doctor can help. Supportive communication is key to reducing patient uncertainty and promoting mental well-being, Rutgers University researchers have found. “Our findings suggest that provider communication is a key component to reducing uncertainty, and thus providers play a key role in helping to facilitate psychological well-being,” said lead researcher Liesl Broadbridge. She’s a doctoral candidate at Rutgers School of Communication and Information in New Jersey. Discussing uncertainties and responding with empathy to patients’ concerns is critical to their healing and recovery, according to the study authors. “Our findings are directly applicable as targets for communication training modules for health care providers, because by continuing to advance skills in empathic communication, clinicians can enhance the health care experiences of their patients,” Broadbridge said in a Rutgers news release. The researchers also investigated how managing psychological well-being differs during and after cancer treatment. Current and former patients have different types of appointments, such as treatment decision-making for current patients and watchful waiting for former patients. They have had different amounts of time to adjust to diagnoses and, potentially, have different relationships with their providers. “Although our findings were true for both current and former patients, the strength of the relationship between uncertainty and psychological adjustment was stronger for former patients than for current patients,” Broadbridge…  read on >  read on >

“Trigger warnings” are now widely accepted as away to help people avoid harm from disturbing content. Trouble is, they just don’t work, according to new research. Trigger warnings seem like an obvious good: They alert people that a book, video or other media will depict a fraught topic such as sexual assault, abuse or suicide. Forewarned, consumers can skip the content or at least be emotionally prepared for it. The problem is, trigger warnings appear to be ineffective at best — and maybe even be harmful in some cases, according to the recent analysis of a dozen studies. The researchers found that while there was evidence that trigger warnings sometimes caused “anticipatory” anxiety, they did nothing to relieve the distress of viewing sensitive material. Nor did the warnings deter people from viewing potentially disturbing content; in fact, they sometimes drew folks in. In sum, the studies “almost unanimously” suggest that trigger warnings do not work as intended, according to senior researcher Victoria Bridgland of Flinders University in Australia. Why then are trigger warnings so prevalent, from college classrooms to theaters and art galleries to news articles and social media posts? Once they caught on, they simply kept growing — likely driven by a sense that they seemed like the “right thing to do,” Bridgland said. “This is probably because we have a culturally ingrained notion…  read on >  read on >